Perbedaan Kadar Cea dan Ca 19-9 dalam Serum berdasarkan Differensiasi Sel pada Kanker Kolorektal

Abstract

Background --- Carcinoembryonic antigen (CEA) and Carbohydrate antigen (CA 19-9) are the most common tumor markers for colorectal cancer. Both have prognostic value. According recommendation by the Colorectal Working Group of the American Joint Committee on Cancer (AJCC) CEA ≥5 ng/ml was defined as elevated CEA level and CA 19-9 ≥37 U/ml was defined as elevated CA 19-9 level. To date in Indonesia, datas regarding serum level of CEA and CA 19-9 characteristic based on cell differentiation in preoperative colorectal cancer have not been avaible yet. Objective --- To evaluate the difference of serum level CEA and CA 19-9 based on cell differentiation in colorectal cancer. Materials and Methods --- The study was conducted from July 2012 to May 2013. Fourty patients were enrolled in the study, 22 males and 18 females. The mean age of patients was 50.78 ± 14.96 years old, 22 males, 18 females. Clinicopathological characteristics and associated follow-up data were cross sectional with comparative analytic. Then to evaluate the difference and correlation serum level of CEA and CA 19-9 based on cell differentiation (histopathologic grading). Result --- Serum level of CEA and CA 19-9 based on cell differentiationwere not significantly different. There were no significant different of CEA and CA 19-9 based on cell differentiation in colorectal cancer with p value 0.314 and .,787 (p > 0.05) respectively. There was no correlation of CEA and CA 19-9 based on cell differentiation, p value 0.475 and 0.247 ( p > 0.05) respectively. Conclusion --- There was no significantly different of CEA and CA 19-9 based on cell differentiation in colorectal cancer.

Latar Belakang --- Carcinoembryonic Antigen (CEA) dan Carbohydrate Antigen (CA 19-9) adalah penanda tumor untuk kanker kolorektal (KKR). Keduanya memiliki nilai prognostik. Berdasarkan Colorectal Working Group of the American Joint Committee on Cancer dikatakan nilai abnormal bila peningkatan nilai CEA yaitu ≥ 5 μg/l dan peningkatan nilai CA 19-9 yaitu ≥ 37 U/ml. Peningkatan CEA dalam serum dapat diperiksa pada penderita KKR pasca operasi bila terdapat rekurensi atau metastasis, mungkin hal tersebut menyebabkan adanya pengaruh differensiasi sel dengan kadar CEA. Demikian CA 19-9 menurut rekomendasi ASCO, dapat melengkapi pemeriksaan pada penderita KKR. Belum ada data penelitian di Indonesia mengenai karakteristik kadar CEA dan CA 19-9 berdasarkan diffferensiasi sel penderita KKR preoperatif. Tujuan --- Untuk mengetahui perbedaan kadar CEA dan CA 19-9 dalam serum berdasarkan differensiasi sel yang berbeda pada KKR. Bahan dan Cara --- Sampel studi adalah pasien KKR (n = 40, rerata umur SD 54,67 ± 14,96, 22 pria, 18 wanita) antara Juli 2012 sampai dengan Mei 2013 diperiksa kadar serum CEA dan CA 19-9. Karakteristik klinikopatologis dan data dasar diperoleh secara cross sectional dengan analisis komparatif. Selanjutnya dianalisis perbedaan serta korelasi kadar CEA dan CA 19-9 berdasarkan differensiasi sel (derajat histopatologi). Hasil --- Tidak dijumpai perbedaan bermakna kadar serum CEA dan CA 19-9 pada KKR berdasarkan differensiasi sel dengan p value 0,314 dan 0,787 (p > 0,05). Uji Chi-square dan Spearman didapatkan tidak dijumpai hubungan yang bermakna dari CEA dan CA 19-9 dengan differensiasi sel dengan p value 0,475 dan 0,247 (p > 0,05). Kesimpulan --- Tidak dijumpai perbedaan yang bermakna secara statistik kadar CEA dan CA 19-9 pada KKR